老年女性急性心肌梗死临床及冠脉造影特点的研究

A Study on the Clinical and Coronary Angiographic Characteristics in the Elderly Female patients with Acute Myocardial Infarction

目的 探讨老年女性急性心肌梗死 (AMI)临床及冠状动脉造影的特点 .方法 对老年AMI10 7例 ,分女性组 (A组 ) 33例 ,男性组 (B组 ) 74例 ,分析其临床症状、血脂水平、冠状动脉病变特点 .结果 ①女性组AMI发病的平均年龄晚 ,平均病史短 ;以胸闷、气短、恶心、呕吐、晕厥等为首发症状为主 ;②两组并高血压均较高 ;③女性组糖尿病及高脂血症史 ,冠脉两支以上病变 ,心功能NYHA分级Ⅲ、Ⅳ级均较男性组高 (p <0 .0 5 ) ;④女性组并发心源性休克和泵衰竭高于男性 (p均 <0 .0 5 ) .结论 女性组发病年龄晚 ,相对病史短 ,临床不典型 ,伴发病及并发症多 。

Objective To study on the clinical and coronary angiographic characteristics in the elderly female patients with acute myocardial infarction(AMI). Methods Retrospective analysis was performed on 107 elderly patients(≥60yrs) with AMI. The patients were divided into 2 groups: the elderly female group (group A, n=33) and the elderly male group (group B, n=74), comparing their clinical characteristics, plasma level of lipid, coronary angiographic characteristics and so on. Results ①The average age of the patients was older and the case history was shorter in group A than those in group B. ②In group A the symptoms such as chest tightness, nausea, vomit, syncope and so on were higher than in group B.③Concomitant hypertension was frequent in the two groups, but there was no significant difference between two groups(p>0.05). ④Concomitant diabetes mellitus, hyperlipidemia, multi-vessel lesions and the cardiac dysfunction(NYHA class: Ⅲ, Ⅳ) were more commonly found in group B. The differences were statistically significant between two groups (p<0.05). ⑤The occurrence rate of cardiogenic shock, congestive heart failure were higher in group A than those in group B. There was significant difference between two groups (p<0.05). Conclusions The characteristics of elderly female patients with AMI include: a relatively shorter history, older age, a series of atypically clinical symptoms, more complications, a high mortality and so on. Treatment in time is very important.